Patrones de prescripción de antirretrovirales en 997 pacientes colombianos

Abstract

Introduction. Antiretroviral therapy for treatment of human immunodeficiency virus type 1 (HIV-1) infection has improved steadily since the advent of combination therapy in 1996.Objective. The pharmacological therapies of the infection by HIV/AIDS were documented in order to determine if effective treatment regimes were prescribed.Materials and methods. Pharmacological therapies of the human immunodeficiency virus infection were compared in 997 patients affiliated with the health security system, of both sexes and all ages. All had been in treatment for more than three months (July-September 2006) and were distributed in 15 Colombian cities. The data were retrieved from medication consumption files which were maintained by the institutions that had distributed medications to the selected patients.Results. The average age of patients was 37.7±13.2 and 82.6% were men. All the patients received between three to five antiretrovirals.  The medications most commonly prescribed were nucleoside reverse transcriptase inhibitors (96.4%), nonnucleoside reverse transcriptase inhibitors (54.9%), protease inhibitors (39.8%) and others (0.4%). All of the doses were at recommended levels.The most common combinations were lamivudine-zidovudine-efavirenz (35%), lamivudine-zidovudine+lopinavir/ritonavir (8.4%), abacavir+lamivudine-zidovudine (5.5%), lamivudine-zidovudine+nevirapine (5.2 %) and others (45.9%), consisting of  65 different combinations.Conclusions. All agents were used at internationally recommended doses and rational prescription patterns prevailed in the initial therapy. However, the use of 69 different associations suggested that after the beginning of treatment, clinicians do not have adequate criteria to prescribe in accordance with international guidelines of antiretroviral therapy; they adopt a variety of options that may be outside of established recommendations.